When it comes to public services, the word “preventative” gets used a lot. For decades now, the idea that we need to shift to preventing crises rather than picking up the pieces after they’ve happened has had close to universal agreement. The problem is that the shift never happened.
When individuals and families start to struggle, they simply do not believe that public services will help. When services do intervene in their lives, it’s almost always because a crisis point has been reached.
Too often, public services lack the kind of deep and long-term engagement with communities that is required to create an environment where people will voluntarily seek help. That would be real prevention.
If anyone understands why people won’t seek help until a crisis point, and how to build the trust needed to change that, it’s civil society. Unfortunately, these voices are currently almost always absent from the rooms where the theorising about public services happens.
Truly preventative
To change this, I convened the Social Insights Panel for the Future Governance Forum, which brings the strategic and frontline experience of civil society organisations – from large national charities to small, local and voluntary groups – to the attention of those in government who are trying to reform public services.
The panel has just published its first report, which focused on three areas: ending violence against women and girls, supporting transitions to adulthood, and building integrated and preventative family support. These are three of the areas in which the government is applying its “test, learn and grow” approach to public service reform, which presents a timely opportunity to consider what a truly preventative approach would look like, and what public services can do to enable it.
We found that the same obstacles to prevention cropped up in all three areas. There was a misunderstanding right across the system of how real prevention – which doesn’t look like traditional public service delivery – is achieved in the first place.
Rather than top-down interventions in a local area, real prevention relies on the resilience, cohesion and support networks that either already exist in communities, or that can be enabled if public services embrace a completely different relationship with local community groups and organisations.
Prioriting trust
The panel identified six breakthroughs, which we believe are vital if the government’s efforts to rethink how public services can become truly preventative are to succeed.
What links them all is a philosophical shift away from seeing services as top-down interventions that are often temporary and reactive, and towards an approach that prioritises trust, community relationships and local context. It recognises the importance of relationships rather than focusing on risk levels and thresholds.
Only by shifting our thinking in this way can we hope to build the kind of effective webs of support across and beyond public services that can help solve the wicked problems that have eluded reformers for generations.
Investing in the edges of the web does more than offer real prevention for people who need it – although that is prize enough. By strengthening bonds between people, and boosting community infrastructure, we can increase trust in public services themselves, and begin to rebuild the fabric of our communities that has split and frayed over the last decade.
The revolution in commissioning practice that this will require cannot be overstated. We believe commissioning culture breaks down the collaboration it should incentivise in the public and social sector, and right now threatens to destroy the fabric of the web of support that is so vital to prevention.
Culture of gatekeeping
True preventative work is about keeping people away from needing too much state intervention in their lives. It is not just a gateway or a holding room. One of the strongest predictors of reduced re-entry into crisis for families struggling with parenting is long-term, continuous relationships throughout the challenges and changes of family life. Only civil society, from its most formal to its most informal structures, can achieve this. But only if it is asked and funded to do so.
For decades local voluntary and community sector groups have called for commissioning behaviours that allow their work to flourish, yet it still very often makes their work more difficult and less effective. Local government funding pressures, in particular, have led to a culture of gatekeeping scarce resources in many councils, which is not only experienced by individuals who need help, but also by organisations who must tender and compete for funds.
A change in commissioning culture and behaviour is an urgent necessity if civil society is to fulfil its potential as a partner in public service reform. It is a fundamental requirement for all the other recommendations we have made to achieve meaningful prevention.
This change fits with something the prime minister hinted at before he was elected. He promised that, if Labour came to power, the state would begin to “tread more lightly on people’s lives”. And in his first king’s speech debate, he spoke of the overwhelming importance of rebuilding trust in government and the services it provides. Those words should have laid the ground for the exact kinds of shifts we are recommending.
Living up to this promise means building the kind of relationships, local infrastructure and community bonds that ensure people can find the help they need, without having intervention imposed upon them once they reach a crisis point. It means strengthening community bonds and social capital to rebuild trust across the UK. And it means shifting our understanding of how public services should be delivered to meet our diverse communities where they are, rather than where government wants them to be.
Baroness Polly Neate is chair of the Future Governance Forum’s Social Insights Panel
